Short Nonfiction: Breathtaking by Rachel Clarke

Little, Brown Book Group| 26 January 2021| 154 pages| 4*

Novellas in November is hosted by Cathy and Rebecca. This week the focus is on short nonfiction.

I’ve watched TV programmes about Covid-19, seeing what it was like in a number of hospitals as the virus took hold in the UK, so a lot of the information in Rachel Clarke’s book, Breathtaking: Inside the NHS in a Time of Pandemic wasn’t new to me. But, I wanted to read this book to get an inside perspective on what it was like working in the NHS during the pandemic.

There have been so many fears that the NHS would be overwhelmed and reports criticising the way the government has dealt with the situation – and this is still the case now as winter approaches and the number of daily confirmed cases of coronavirus is still high, whilst hospital waiting lists for non-Covid-19 treatment remain high. Add to this there are now reports that doctors are saying that casualty departments are on the ‘edge of a precipice’, leading to dangerous levels of handover delays with patients forced to wait in ambulances for up to 11 hours outside hospitals. On TV I’ve seen the enormous queues of ambulances outside hospitals waiting to admit patients!

Rachel Clarke is a palliative care doctor and her book recounts her experiences during the first four months of 2020, when she worked on the Covid-19 wards in the Oxford University Hospitals system. Taken from her diary that she kept at the time it has an immediacy as she records her insomnia, her fears for her family and also the tremendous resilience, courage and empathy that she and the rest of the hospital staff had.

She tells the now familiar story about the PPE shortages, the lack of funding they experienced and criticises the government for their failure to act quickly enough – which I echo. Although it is a grim account, as I expected, it is also uplifting to know the care they took of their patients and the attentiveness to their patients’ needs despite the fact that many of the staff were not trained in intensive care and had never dealt with anything like this before.The way they had to prioritise patients is shocking, but I suppose inevitable given the lack of resources and staff.

She found that being a pandemic doctor was revelatory:

The crisis has undeniably revealed sweeping truths about social and economic inequalities, class divisions, global interconnectedness and the fact that our society’s most vital key workers were, and remain, among the lowest paid and the least empowered. Historians will dissect the issues for years to come. My revelations were about people. I learned from ward to ward, from bedside to bedside, paying meticulous attention to one human being and then another. I discovered how to distinguish what we absolutely cannot do without from what is really in the end, superfluous. (page 18)

This book is a snapshot, written at the time:

It depicts life and death, hope, fear, medicine at its most impotent and also at its finest, the courage of patients in enormous adversity, the stress of being torn between helping those patients and endangering your spouse and children, the long, fretful nights ruminating over whether the PPE you wear fits the science or the size of the government stockpile. I needed, I think, to take a stand with my pen and simply say: I was there. I have seen it, from the inside. I know what it was like. Here, with all its flaws and its inherent subjectivity, is my testimony. Make of it what you will. (pages 18-19)

Breathtaking records the compassion and kindness of numerous people, and pays tribute to both NHS staff and volunteers in dealing with such a distressing and immensely horrific situation.